Covid road for PNG bumpy & vicious
23 April 2021
MELBOURNE - There was a time when it seemed Papua New Guinea had managed to dodge a bullet.
Instances of coronavirus were minimal, along with its disease, Covid-19. Through 2020, the country of nine million people recorded a mere 900 cases.
The World Health Organisation praised the PNG government in September 2020 in “taking the threat of the pandemic seriously with an all-of-government approach in strengthening the country’s health system and engaging communities to keep them safe from the virus.”
Officials acknowledged that a spike in cases could impair the medical system, despite the fact that three-quarters of the population are under the age of 35.
While the elderly population is small, the large number of youthful members poses the problem of asymptomatic transmission.
“We know that about 15% of Covid-19 cases will need some form of hospital care,” stated Dr Gary Nou, an important figure in the Covid-19 response in the National Capital District.
“If 10,000 people get sick – that’s about 1,500 people needing care. This can easily overwhelm our health system.”
Last month, Nou found himself working to a state of exhaustion in the Rita Flynn Sporting Complex in Port Moresby.
The complex had become a centre of treatment and testing, taking in moderate and mild coronavirus cases. Nou concluded that a nightmare was unfolding.
“The workload is normally a lot, we have one doctor per 14,000 people, that’s our doctor to patient ratio.” The health system, he gloomily observed, was now in a “perpetual state of disaster”.
Currently, the number of coronavirus cases has almost reached 9,800 with 89 deaths recorded. But these figures may well be skewed.
Moses Laman of the PNG Institute of Medical Research told Devex at the start of this month that the figure of 100,000 was “closer to reality” given that one in five tests returned a positive result. “That tells us there is widespread community transmission.”
Australian Doctors International’s Mimi Zilliacus does little to dissuade on that score, noting that minimal testing has taken place in the provinces.
“Lots of provincial governments have been reluctant to act, even when the response from the central government has ramped up.”
At the start of this month, the PNG Epidemic Response Group, an alliance comprising medical research institutes, NGOs, professional services and Australian churches, warned of an impending calamity.
It urged the Australian government to “immediately allocate one million of its domestically produced vaccines to PNG now, along with accompanying technical assistance and support for the PNG government and communities to address vaccine hesitancy and distribution.”
Concerning is the number of health workers being infected, a result largely due to a crawling vaccination program. PNG health minister Jelta Wong promises that “558,000 doses of the AstraZeneca vaccine will be made available to Papua New Guineans” by June, though he could not muster much certainty on the timing.
Structural problems are also bound to blight any vaccination distribution, not least because most of the country exists in a state of electricity deprivation.
In parts of the world where electricity access is poor, note three authors on The Conversation website, “refrigeration of vaccines during transport and storage may prove very difficult.”
The rash of cases in PNG has done enough to worry the World Health Organization. Its director-general, Tedros Adhanom Ghebreyesus, was gloomy at a virtual press conference a week ago.
The numbers might have been “smaller than other countries” but the increase was worryingly sharp. PNG was, he argued, “a perfect example of why vaccine equity is so important.”
The country had held Covid-19 “at bay for so long” but faced a rise in infections, fatigue towards social restrictions, low levels of immunity in the population and a fragile health system.
This has also worried Australia, a country so often inclined to treat PNG with a mixture of splitting headache, condescension and hopeless charity.
Ian Kemish, former Australian High Commissioner to the country, calls it Australia’s “blind spot” despite PNG being home to some 20,000 Australians.
The former diplomat is unabashed in stressing the virtue of self-interest, which he calls “an important motivator of public attention”. What is good for PNG, he unequivocally asserts, is also good for Australia.
Kemish even goes so far as to praise representatives of Australian mining, with their “world-class testing and treatment protocols” (they can, the implication goes, teach the natives a thing or two).
In such praise, he chooses to avoid the obvious question: that PNG’s heavy reliance on mining provided another avenue for coronavirus to enter the country and thrive. A stream of revenue may well have also constituted a viral route.
The Australian Council for International Development is blunter. As Marc Purcell, its chief executive, stated with a note of alarm, any virus mutations in PNG threaten “to undermine the Australian vaccines program.”
(At this stage, there is not much to undermine: Australia’s vaccination program remains incipient, tardy and barely worth a mention.)
Canberra’s lack of a coherent vaccination strategy and lamentable planning has meant that parts of northern Australia are vulnerable to possible infection. Proximity to PNG is a factor.
Of particular concern are the residents of the Torres Strait, their health potentially fragile to the ravages of the virus.
In the words of Bill Bowtell, famed for his role behind Australia’s successful HIV-AIDS response, “the Torres Strait is paying the same price as the rest of Australia for a lack of coherent planning about supply and then obviously distribution.”
Queensland deputy premier Steven Miles has expressed a growing worry from the view of the state government.
“There are islands in the Torres Strait where you can see PNG from the beaches and where it is very common for people to travel for traditional trade purposes between PNG and the Torres Strait islands”.
It was essential to “get as many of those folk that we know are vulnerable vaccinated as quickly as we can,” Miles said.
In late March, Australia donated a paltry 8,000 doses while 132,000 doses from the global COVAX facility arrived last week.
Concerns remain with the use of the AstraZeneca vaccine, given the bad press that has enveloped it regarding instances of rare blood clotting.
The road ahead for PNG looks bumpy and more than a touch vicious.
Binoy Kampmark was a Commonwealth Scholar at Selwyn College, Cambridge. He lectures at RMIT University, Melbourne
Another gem from Jonathan Cook on Counterpunch:
Posted by: Bernard Corden | 23 April 2021 at 05:36 PM
Across the democratic world denial, blundering incompetence, confusion, wishful thinking and indifference have been the common hallmarks of the response to Covid-19.
The political class has, with very few exceptions, made a complete hash of managing the pandemic.
At the heart of their now painfully obvious failings has been the inability to understand that there is no workable trade off between dealing with a public health emergency on a global scale and a desire to keep the economy going at a close to normal rate.
Politicians have tied themselves in knots trying to figure out how to simultaneously achieve what are mutually exclusive goals. This is probably because they are so used to adopting mutually exclusive policy objectives without either they or the public necessarily understanding what they are doing.
A simple example is the persistence for many years in Australia (notably at the Federal level) of the idea that "efficiency savings" can be achieved whilst simultaneously achieving higher standards of care and churning through more cases in the costly but desperately under resourced and overstressed health and aged care systems. Now we all know differently but recovering from years of this idiocy is a slow process.
Another obvious example is the Australian Federal government's irrational and ultimately self defeating position on climate change, where attempts to square the policy circle between the rabid pro-carbon, climate change denying party "base" and the obvious reality of climate change continues to bedevil attempts to respond to the looming crisis intelligently.
I lay the blame for this firmly at the feet of the world's various conservative parties. Their blithe acceptance of the shibboleths of neo-liberal capitalism has been an unmitigated disaster in many respects and they remain utterly bewildered as to why bad things are beginning to happen.
Why, for example, privatising large chunks of government activity has not resulted in cheaper, more efficient and higher standards of services. Why wage growth, having been ruthlessly suppressed by various anti-labour measures for decades, has resulted in an inability to fuel consumption and hence the much desired "moderate" inflation required to grow the economy in the neo-liberal model.
In the context of the pandemic, what this has meant is that a weakened public sector has, typically, been especially ill prepared to respond to the challenge, not because of a lack of knowledge or will but the lack of "boots on the ground" just when they are needed. The "Just in Time" philosophy of resource management may work in a car factory but it is a disaster waiting to happen when it comes to critical public health infrastructure and resources.
So here we, unable to even respond effectively to the need to vaccinate our own population as a matter of urgency let alone PNG's.
As the death rate climbs relentlessly, our stupid political class just cannot get their heads around the problem and hence what needs to be done.
The Federal government has persistently made a whole series of wildly optimistic assumptions about things like the vaccine supply chain, the effectiveness of vaccines, the ability to persuade a suspicious public to line up for a shot, the logistics of rolling out 50 million doses of vaccine and so forth.
The much more grounded State Premiers have, fortunately, been able to largely prevent the Feds from being their worst selves but were deliberately cut out of the loop on the vaccination program by the over confident Feds.
The Fed's approach has been a triumph of spin over substance, no doubt reflecting the current PM's instinctive preference for announceables and marketing spin over actually doing anything.
Here, in simple terms is an explanation for them: its an emergency, stupid!
Throw everything at it now! Forget the budget deficit, just do something useful! Mobilise the military, whose raison d'etre is logistics. They know how to move lots of people and stuff from point A to point B. They can do something useful both in Australia and to help our PNG friends and other Pacific neighbours.
It is not rocket science, jut a question of the will to do an intelligent thing.
Sadly, doing an intelligent thing seems to have fallen badly out of fashion in a political world where the pursuit and retention of power is now the whole point of the exercise and expediency is the ruling philosophy, not trying to understand, articulate and implement decisions in the public interest.
Posted by: Chris Overland | 23 April 2021 at 09:31 AM